BVA9500565 
DOCKET NO.  93-04 292     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Columbia, South
Carolina

THE ISSUES

Entitlement to an earlier effective date for the assignment of a
total disability evaluation for chronic, undifferentiated type
schizophrenia with features of post-traumatic stress disorder
(PTSD), prior to February 5, 1991.

Whether total disability from chronic, undifferentiated type
schizophrenia with features of PTSD is permanent in nature?

REPRESENTATION

Appellant represented by: Paralyzed Veterans of America,
Inc.

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

R. K. ErkenBrack, Counsel

REMAND

The veteran had active duty from September 1968 to June 1971 and
from August 1974 to April 1977.

The service and postservice medical records indicate psychiatric
diagnoses of chronic, undifferentiated schizophrenia, acute
anxiety, passive-aggressive dependent personality with history of
drug dependency and antisocial actions, depressive reaction,
mixed substance abuse - opiates and alcohol, PTSD with a history
of
poly-substance abuse/dependence (panic attacks), generalized
anxiety disorder, recurrent major depression versus bipolar
affective disorder, and panic disorder with agoraphobia.

The veteran has not received a Department of Veterans Affairs
(VA) psychiatric rating examination for many years, although his
psychiatric status has been evaluated and treated repeatedly at
VA Medical Centers and Mental Health Clinics, the most recent of
record having been at VA Medical Center, Charleston, South
Carolina, in November and December 1992.  With respect to the
issue of permanency of total disability from service connected
psychiatric disablement, his representative requests a current
rating examination with an opinion from the examiner as to
prognosis of the psychiatric disability.  In this regard, it is
claimed that substance abuse is a manifestation of psychiatric
disablement and a consequence of self-medication for such
disablement.

To ensure that the Department of Veterans Affairs (VA) has met
its duty to assist the claimant in developing the facts pertinent
to the claim and to ensure full compliance with due process
requirements, the case is REMANDED to the regional office (RO)
for the following development:

1.  After obtaining the veteran's written
authorization for the release of medical
records, the RO should obtain the complete
medical records covering the veteran's
treatment at Charlotte Mental Health
Clinic, Billingsley Road, Charlotte, North
Carolina, 28211, and treatment at Charlotte
Memorial Hospital, before the veteran was
transferred from there on September 17,
1987, to the VA Medical Center in
Salisbury, North Carolina.

2.  The RO should obtain all the outpatient
and hospital treatment records from the VA
Medical Centers at Charlotte, Salisbury and
Durham, North Carolina, and Columbia and
Charleston, South Carolina, including all
the records of hospitalization in October
1971 at Salisbury, North Carolina, February
and August 1976 at Durham, North Carolina,
and outpatient treatment records in 1973
and 1974 at Charleston, South Carolina.

3.  The veteran should be afforded a VA
psychiatric examination to ascertain the
severity and all the diagnoses of his
psychiatric disability picture.  All
indicated psychological testing should be
accomplished.  The claims folder should be
made available to the examiner for review
before the examination.  It is requested
that the examiner designate all outstanding
psychiatric diagnoses the record supports
to be present, and render an opinion on the
prognosis of the veteran's psychiatric
disablement and the separate disabling
effect of substance abuse, if it can be
separated, and whether such substance abuse
is a primary condition or a manifestation
of service-connected psychiatric
disablement.  The rationale for the
conclusions reached would be appreciated.

4.  The RO should obtain the veteran's
vocational rehabilitation and education
counseling folders and associate them with
the claims folder.

5.  After the development requested above
has been completed to the extent possible,
the RO should again review the record.  If
any benefit sought on appeal, for which a
notice of disagreement has been filed,
remains denied, the appellant and
representative should be furnished a
supplemental statement of the case and
given the opportunity to respond thereto.

Thereafter, the case should be returned to the Board, if in
order.  The Board intimates no opinion as to the ultimate outcome
of this case.  The appellant need take no action until otherwise
notified.

          BRUCE E. HYMAN.
          Member, Board of Veterans' Appeals

The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to be
assigned to an individual member of the Board for a
determination.  This proceeding has been assigned to an
individual member of the Board.

Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals.  This remand is in the nature of a
preliminary order and does not constitute a decision of the Board
on the merits of your appeal.  38 C.F.R. § 20.1100(b) (1993).